The CARE model is a research-informed framework created by the BCTR's Residential Child Care Project (RCCP) designed to enhance the social dynamics in residential care settings to serve the best interests of the children. The model involves an ecological approach to engage all staff at a residential care agency in a systematic effort to provide developmentally-enriched living environments, to create a sense of normality, and to improve the socio-emotional and developmental outcomes for children.

“Attaining this level 3 scientific rating has been a goal since CARE’s inception in 2005,” said Martha Holden, RCCP director and creator of CARE. “Twelve years ago, we set on this path and we have been working toward this goal ever since.”

The plan going forward, Holden explained, to continue to study the CARE model to advance its rating to Level 2, which indicates it is supported by research evidence, by implementing and studying the program at residential facilities throughout North America. “We know this will take at least an additional five years under the best of circumstances,” she said.

“Recent questioning of the appropriateness and effectiveness of residential care has led to the need to define and build a sound foundation for quality services for high-resource needing children and youth with multiple challenges,” Holden said. “Quality therapeutic residential care requires adherence to a system-wide, evidence-based program model. With continued development and research of the CARE model, the Residential Child Care Project hopes to provide additional evidence to improve the quality of residential care.”

CARE is used in more than 50 agencies in the USA, Canada, Australia, and the United Kingdom, all collecting data and contributing to the on-going development of the knowledge base of what works in residential care.

The CARE model is based on six core principles that care should be: relationship-based, trauma-informed, developmentally-focused, competency-centered, family-involved, and ecologically-oriented.

In March Martha Holden (Director of the Residential Child Care Project) traveled to the Northern Territory, Australia at the invitation of Howard Bath, the Children's Commissioner of the region. The Children's Commissioner, whose core function is to ensure the well-being of vulnerable children, is working to overcome disadvantages that Indigenous children and families face and improve their quality of life. Currently there are a large number of Indigenous children placed in out-of-home care. Residential programs (mainly smaller group homes) have grown rapidly in response to demand, but with little theoretical coherence or regulation. The current departmental administrators are well aware of this issue and are seeking to chart a new course. Holden's visit was seen by administrators as an opportunity to gain information on theory, structure, monitoring, and quality care that will shape their thinking and planning.

Additionally, youth services and residential care staff and professionals attended Children and Residential Experiences (CARE) Seminars presented by Holden in Alice Springs and Darwin. The attendees were introduced to the CARE therapeutic care model and its six key principles of being:

The ACWA conference was held August 20-22 in Sydney. Holden co-presented a workshop, CARE: Creating Conditions for Change on implementing the CARE model in two organizations in Australia with Diana Boswell, Director of the Thomas Wright Institute, Canberra; Hilary Martin, Director of Marymead Child and Family Services, Canberra; and Leith Sterling, Director of Professional Development, Anglicare Southern Queensland, Brisbane. Holden and Boswell have been working with these two residential services organizations for the past year helping them implement the CARE program model throughout their organizations.

There is currently great interest in implementing a more therapeutic approach to care for children in statutory care living in residential facilities in South Australia. Holden was invited by the Australian Centre for Child Protection at the University of South Australia to meet with the new Director of Residential Services (the statutory agency) in South Australia, Dana Shen, who is actively exploring the application of a therapeutic model of care with staff and providers. She also presented to managers from the statutory agency and the principle service providers about the principles of therapeutic care in the CARE model and to discuss implementation. Finally, she met with the Australian Centre for Child Protection research team to talk about the evaluation process in the CARE model and discuss how to embed some sort of evaluation and quality control in re-designed services from the outset. The Centre saw the potential to shape the development and nature of residential services in the State into the future.